Federal quality reviewers and regional MCs or PCs consider all evidence in the paper MDF to evaluate the accuracy of the adjudicating component’s disability determinations. For processing instructions, refer to Federal Quality Review of State Disability Determinations GN 04440.000.

If you have not received the prior paper folder, but it is necessary to perform the QR, request the prior paper folder from the adjudicating component. Remember to correct the paper folder indicator (PFI) and prior paper folder indicator (PPFI), if necessary.

If you do not receive the prior paper folder and decide that it is not necessary for the QR, you can correct the PFI and review the case.

If the prior paper folder is necessary and you don’t receive it after contacting the adjudicating component, exclude the case from sample review.